It Takes Heart
It Takes Heart is an unmissable podcast where healthcare workers share their honest and unique experiences from Australia’s frontline.
Discover real-life stories of passion and purpose, insight and inspiration from people on the inside and tales that are equal parts heart-warming, heart-wrenching and hilarious. It Takes Heart is co-hosted by cmr | Cornerstone Medical Recruitment CEO Samantha Miklos and Head of Talent and Employer Branding Kate Coomber.
It Takes Heart
The Rural Doctors Foundation: Redefining Care for Those Who Give It
Who cares for the carers? Discover how one foundation is quietly reshaping rural healthcare.
In this heartfelt episode, we speak with Fran Avon, CEO of the Rural Doctors Foundation, and rural GP Dr. John Buckley. Together, they reveal the hidden struggles faced by rural doctors who serve as the backbone of their communities. From responding to catastrophic floods to managing everyday burnout, we explore why supporting rural doctors is essential to sustaining healthcare in remote Australia.
You’ll hear the inspiring origin story of the Rural Doctors Foundation, born out of crisis and driven by compassion. Their flagship initiative, GPs for Rural Docs, brings confidential medical care directly to rural practitioners, care they often go without due to stigma or isolation. Dr. Buckley shares powerful moments from the field, reminding us just how deeply personal rural medicine can be.
This episode is essential listening for anyone passionate about improving rural healthcare, championing doctor wellbeing, or building stronger, more resilient communities. Fran and John’s mission reminds us that by caring for those who care for others, we ensure a healthier future for all.
It Takes Heart is hosted by cmr CEO Sam Miklos, alongside Head of Talent and Employer Branding, Kate Coomber.
We Care; Music by Waveney Yasso
More about Fran & John's Organisations of Choice, Rural Doctors Foundation
Rural Doctors Foundation is a national rural health charity committed to improving access to life-saving healthcare in Australia’s rural and remote regions. Led by rural doctors and local community members, the foundation supports healthcare where it’s needed most, from the remotest outback towns to vibrant coastal hubs and rural farming districts.
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Welcome to it Takes Heart. I'm Kate and I'm Sam, and we can't wait to share more incredible stories of healthcare professionals making an impact across Australia.
Fran Avon:Dad's not just a doctor. He's the counsellor, he's the listening ear, he's the person that people turn to, and so that's why it's so important that we support our rural health practitioners during crisis.
Kate Coomber:Don't forget to hit follow or subscribe if you want to hear more stories from inspiring healthcare professionals.
Sam Miklos:So with each episode of it Takes Heart, we are donating to a charity of the guest's choice, and in my episode in season one, I chose Rural Doctors Foundation. I really felt the foundation aligned with the work that we do, but we loved the fact that they work so hard to improve the health of rural communities. The rural communities has been a common theme in many of our episodes since, and we thought it would be great to better understand the work that the Rural Doctors Foundation do. So today we are joined by their CEO, fran Aver, as well as Dr John Buckley, who is one of the incredible GPs participating in one of their programs, and we really look forward to learning more. Welcome to the both of you to it Takes Heart.
Kate Coomber:Thank you, thank you, so tell us a little bit more about the foundation and the work that you do so.
Fran Avon:The foundation started in 2016, and it was after the floods that decimated a lot of Queensland and a number of rural doctors who were very passionate about the fact that communities and the doctors were left without access to healthcare, to services, and so they wanted to do something in times of crisis, and so that's how we started, and it was very much a volunteer organisation run by a number of rural doctors and with support from the Rural Doctors Association of Queensland, and the story's been amazing because it started with that purpose, but it's grown since then and it's very much.
Fran Avon:We're still doing our emergency work and, obviously, the recent floods in Townsville, we've been helping out some GPs in the community there to provide support, but we're doing a lot more now. We're providing grants to people that are living in rural communities or are the health practitioners in those rural communities to get health initiatives off the ground that they may not have been able to without some seed funding or without a bit of support, and it's really great for us to see, like you know, five, 10 years later, some of those programs are, you know, really big programs now, or you know they've been able to continue because of our initial work with them and one of them is my inspiration. It's Heart of Australia and they. You know we were one of their first supporters. And it's Heart of Australia and they. You know we were one of their first supporters and I look at them now and I go.
Sam Miklos:Oh, we want to be like them.
Dr John Buckley:So it's really great.
Fran Avon:We also do research into health issues and really try and understand what's happening out there for our rural health practitioners, and we also, you know, the program that John is a part of is very much about looking after the health of our rural health practitioners. So we're going out into rural communities with GPs to provide GP services for our rural health practitioners, who people you know really need independent support. But obviously John will talk about that a bit more because he is.
Kate Coomber:Yeah, the program's really interesting. I'd love to hear so you're a general practitioner, Is the work that you're doing in this program? Is that the side hustle?
Dr John Buckley:No, that's my main clinical work now.
Kate Coomber:This is your main clinical work now.
Dr John Buckley:If this was video, you'd see my grey hair.
Kate Coomber:It is.
Dr John Buckley:Yeah, but it's been a passion of mine for a long time. I spent most of my medical career working in GP education and training, and particularly with a focus on rural training. So I've watched doctors come and go, I've watched how hard it is to recruit, and you guys know about that.
Dr John Buckley:And I've watched burnout and I've watched people people leave and I've watched the stresses they have. So when this program came up just as I was leaving the practice, I was working and I thought that's a fantastic bit of work to do. I still do other work as well, but that's my main clinical work now is to have this great privilege of seeing friends, colleagues and people I've never met and trying to sustain them in their work in the rural areas.
Sam Miklos:So how do you do that? Yeah, maybe explain the program.
Dr John Buckley:What does?
Sam Miklos:a day in the life of your role. Look like I mean yeah, how does that program work?
Dr John Buckley:So the program is magnificently set up and that's how I sort of came across is when they first announced it and it's a goal that the idea is that we go to several towns. It's a pilot program at the moment so I have the privilege of going to Stanthorpe, gundawindi and St George and my colleague John Duyere goes to three other towns and we're evaluating how that goes. So on a week of a trip, I'll just head out to St George on day one have a nice beautiful drive. I love driving out there.
Kate Coomber:Are you based in Brisbane?
Dr John Buckley:I live on little Coochie Mother Island, just off from the coast, so I head out there and then I'll stay overnight and in the morning I'll set up, pop into a generous clinic in St George and spend a fair bit of the day there seeing whoever wants to see me, and then I'll bid my car and drive to Gundawindi. When you say whoever wants to see me and then I'll bid my car and drive to Gundawindi, when you say whoever wants to see you, is that the staff in the practice?
Dr John Buckley:No it's not really the staff. It's open to any health practitioner in that town or area who wants to come. And what I really love about the setup is it's completely independent. So I don't work for the Rural Doctors Foundation and I don't work for the practices. I am my own self and all of the records for confidentiality purpose are kept entirely separate. I don't log into the systems in the practice. No one really knows who comes except the reception staff, and even for them I just give them a piece of paper saying here are the people coming today and they destroy it at the end of the day.
Kate Coomber:And I guess, why is that important?
Dr John Buckley:It's really. I think for many people it's important for their health anyway that they have privacy concerns and issues. But when you're in a small town if you've ever lived there gossip's a terrible thing and for most people it's one of the reasons for the program. They can probably see a colleague about most things but not about everything. And if there's issues of sexual health, of domestic violence, of mental health issues, they often don't want friends and colleagues and others to know. So that privacy and confidentiality that we all want for those areas of health is critical to maintain and it's hard to share that with a colleague with whom you work in the same practice or the same town. So having someone come into town who's separate from all of that, keeping records separately, and even at the practical level, if you need a certificate for time off work, you're probably not going to ask your boss for that it's really difficult.
Sam Miklos:You just don't think about that at all.
Dr John Buckley:Yeah, People don't. And what Fran mentioned, the research and these are things we've always known, but the Rural Doctors Foundation research has highlighted that all of these things we've suspected are now true and proven and that really helped guide the setup of the program.
Sam Miklos:You know, Fran, you mentioned earlier about when there's a flood, and again we think floods about houses and people, then homelessness. But we don't actually think about services, or it's probably not front of mind. And then you said we go in and we help out. What does the foundation? What does that mean? What are the foundation? Are you sending in doctors, are you?
Fran Avon:and it it depends upon the crisis but, in the past we have flown doctors into rural communities to be able to provide support and services at the time. For some of them it's about like a hardship payment, like a GP or a health practitioner. Their home's been totally destroyed and how do they get back on their feet?
Kate Coomber:very quickly Because you want to make sure they stay there.
Fran Avon:Exactly, and you want to make sure that they're there for the community, because in times of crisis, people turn to people like their GP or their nurse, because they are trusted. They are the people that you want to see. That it's okay. You know this crisis, we're going to get through it. And that's probably one thing that I've learned in my time at Rural Doctors Foundation the role of those sort of people in their community. It has like a real weight. Those sort of people in their community, it has like a real weight.
Fran Avon:It's a very big burden for some of the rural health practitioners to carry that they are always the person that people look to and one of our board directors his father, is a rural GP, and he said Dad's not just a doctor, he's the counsellor. He's the listening ear. He's the person that people turn to, and so that's why it's so important that we support our rural health practitioners during crisis, and so our you know appeal is very much about do we give equipment to get them up and running, you know, do we send?
Dr John Buckley:in medical supplies.
Fran Avon:What is it that we need to do so that healthcare can continue? In one case, we provided funding for a GP to work out of a hotel room for telehealth to be able to continue serving his patients in a different way, of course, but at least he was able to make sure they had their prescriptions, make sure that they were able to continue to get healthcare maybe not in the same way as prior to the crisis, but, yeah, so it does depend on the circumstances, so it does look very different for each type of crisis that we're responding to.
Sam Miklos:And is the work that you do Queensland specific?
Fran Avon:too? And is the work that you do Queensland specific, nationwide? We started as a Queensland charity but, you know, very exciting that we are now a national charity. And obviously you know, as John mentioned, the trial of the GPs for Rural Docs started in Queensland because that's where we've got our roots and we've got our networks. But you know we're very excited that we've just received some funding that will enable us to take it outside. But you know we're very excited that we've just received some funding that will enable us to take it outside of Queensland. That's wonderful and you know that's where we want to get to that every rural community across Australia has access to the services that we provide.
Kate Coomber:Because I guess you're touching a small amount of rural communities at the moment, presumably Maybe paint a picture for people listening of what does it typically look like the communities that don't have access to this? Are they avoiding their own health? Is there wait lists? Are they having to leave communities Like what's the alternative?
Fran Avon:So when we did the research, the alternatives were, as John mentioned, they were seeing a colleague. That may not be I'm sorry, it's quality healthcare, but it may not be the best healthcare for an individual. They were travelling, and so they were travelling, you know, 700 kilometres just to get their own healthcare, and that's obviously a burden on the GP or the health practitioner. But what it also means is that community is left without a GP, and that could be for up to a week. And so what that means is, you know, there's probably 75, 150 people that don't see their GP while they're away. Yeah, and what we're doing with this program is making sure that they're in their community so that they're there for the community, and those appointments are there. They're available because the GP hasn't had to travel to get their own health care.
Sam Miklos:What other programs do you offer Like? Is there additional programs to the one that John's on? Is there any of those you could tell us a little about?
Fran Avon:Sure. So we're doing it in other communities. So, as John mentioned, we've got Dr John Doyer who's doing the communities of Charleville, quilpie, cunnamalla. We're also looking at other communities that we can expand the service to and we've just had an announcement of some funding from Western Queensland PHN which will enable us to deliver the service to Blackall and Buckholden. We've had a corporate partner come on board and they're going to fund the service in Blackall and Buckholden.
Fran Avon:Okay, fantastic, we've had a corporate partner come on board and they're going to fund the service in New South Wales. Not all of New South Wales, yeah, yeah, but some of the communities in New South Wales. So really, that's where we're at and that's why, at the beginning, when I talked about Heart of Australia being the inspiration, you know Dr Gomes, he mortgaged his house and started that program. And now you look at the program and you know, speaking with Ralph, he sort of talked about how, in the early days, you know, couldn't get anyone to support the program or fund the program and a couple of things happened that few people came on board and then it was a bit like a snowball.
Kate Coomber:Yes.
Fran Avon:And that's what I kept saying to the team.
Fran Avon:We've got a very small hardworking team and I keep saying we're still pushing that snowball up the hill but, you know, with these two recent rounds of funding, it's encouraging and we just hope that this is the beginning of other people going. Yeah, we really do need to look after our healthcare professionals and we really need to make sure that they're healthy so they can look after us, and so obviously, we want other partners to come on board so that we can offer this service to every rural and remote community across Australia. And, a bit like Ralph, we took a leap of faith, we invested our own funding to get the program off the ground and to demonstrate its impact. And you know, I'm sure John will share some stories, I can share some stories, but it really is having an impact and that's so encouraging for us.
Kate Coomber:I'd love to hear yeah, John, could you share something with us that really shows and demonstrates that impact?
Dr John Buckley:There's one GP I've seen as a patient who is one of the most respected GPs I know in rural Australia. He's been there a long time and that GP was driving a long way as Fran suggested to get healthcare and trying to fit it in with family trips to the coast and found it just didn't work. So they had really been managing care by doing their own referrals or getting a corridor chat with someone and hadn't had any coordination of their own health care for 15 years which when they think about their own patient.
Dr John Buckley:Of course they would think is terrible.
Sam Miklos:I was just about to say that would be so conflicting for them as well. It's awful.
Dr John Buckley:And so it's not that and it's almost a bit like the American system. You know, I'll get myself off to see this specialist and that specialist, but nobody looking after their general health or their coordination, which is what general practice is so critical. And they knew it, but they didn't feel they had an option. And suddenly this project was happening and they had an option that they wanted to try and work, and so that's an obvious thing.
Dr John Buckley:The other thing that's happened the program was initially conceived to help look after doctors and then it changed to all health professionals, and when I looked at that and went out on a reconnaissance trip and talked to people, I realised it's just as hard for a local allied health person or a local nurse, community nurse or hospital nurse to see the doctors that they work with in a small community, and so the challenge is just as strong for allied health, nursing and other health practitioners. And so again, part of the pleasure has been meeting and having a few patients who are not doctors, which is not what I expected when I joined the program, and it's actually a delight to understand their barriers and to have them relax about the confidential nature, and I know medicine's always supposed to be confidential, but it's hard to trust that in a really small community, in a small place. So that's been an extra bonus to see that those people have the same barriers and how important the program is.
Kate Coomber:Because I think as much as there's obviously going to be confidentiality, but you can have a conversation in a clinic room and then see them in the supermarket 10 minutes later. There's still going to be that feeling that you have. I imagine it's awkward yeah.
Dr John Buckley:You can manage it and you can both sort of smile inwardly and think that's okay, yeah, but it's not the same. Or you know your kids are at daycare together or you play tennis together yeah, and there's others there with you and if you've got a sense of I know something about you and they look at you, it's hard and I lived, you know, a few years in a very small town.
Sam Miklos:And you know you don't get a feeling of privacy about yourself. Yeah, A real theme in some of the conversations we've had has been about the impact that the community can have on attracting healthcare professionals to these rural communities and the impact they can have not only in the attraction but the retention piece of healthcare professionals, doctors and allied nursing. What have you seen in some communities that they're doing really well to attract and retain health professionals, or what would you love to see more of?
Dr John Buckley:I'll just mention first, I view this program as a retention issue because recruitment, you know, is difficult and very expensive and long-term and then you keep losing people and so retaining people. And at some point someone from research said oh, patients are just saying why don't you just come out here and see the patients? I said well, maybe if I look after your health practitioners they'll stay and they can see you much better than if you're turning them over and getting new ones all the time. The other thing that sort of is triggered by that is, each of the towns I go to is very, very different. You know, stanthorpe has a lot of health practitioners, gundawindi is desperately short and St George is big in some areas and not in others.
Dr John Buckley:So the recruitment and retention varies depending on what's going on in town, how far away it is and involvement of organisations like local government, who I know the Foundation has been really important talking to that. Those local governments can help and support a program like this, even in small ways. So what you see is where there is community support and local government support and a few other things to attract people and help look after their families, it goes much better. So when the whole community, government people and other organisations after their families, it goes much better. So when the whole community government, people and other organisations are involved, you get better recruitment and better retention. Where there are struggles in the community or a lack of support from state or local government or a lack of support or understanding from community, all of those things become far more difficult. So it's not so much about the people who are trying to recruit, it's about what's there for the people they are recruiting to help them come and stay.
Kate Coomber:We've heard that a bit, haven't? We about the community almost have a role to play in the recruitment and retention, I guess. What are your thoughts to that? What can a community do to really help?
Sam Miklos:Yeah, what are some examples of things you see.
Dr John Buckley:I had a great story from a friend of mine many years ago. She was at a conference in Canada and you know how they have all these stalls at the conference. Local remote communities had stalls and they had signs up and they were getting doctors on their way past and saying why don't you come to us? And the community would get together and raise funds to own a clinic building or to provide accommodation or to do other things. So the community as their own initiatives, putting forward things to make recruitment and retention easier, and particularly when you think about families. So it's one thing to get a health professional, their spouse has to be happy, yeah we always say that If they haven't agreed with the offer, there's no point.
Dr John Buckley:So get a job for the spouse.
Sam Miklos:Yes.
Dr John Buckley:Or, you know, have a spouse who wants them to be live-out, and I've certainly got friends who are only working rurally because their spouse is from a family who's on a property. And then there's the different ages of kids. You know you can have little preschoolers anywhere, but once you reach school, and especially once you reach secondary school, you get this moment for a family to decide do we school locally, do we boarding school or do we leave? And you know family will come first. So thinking about those services, how to support families and engage families and make them part of the community, having sporting clubs and community organisations, whether it's Lions or whoever else it might be looking after, supporting and involving spouses and kids, is really important, and so the community has to initiate that. They have to recognise the need to have the whole family involved in their community, not just to have the doctor or the nurse here and perhaps befriend them, but isolate their family.
Sam Miklos:Do you think most communities are aware of the importance of having the healthcare professionals there, or is it taken for granted?
Fran Avon:I think you know, as John said, every community is different.
Fran Avon:And as we've gone out to them. There's some that you go wow, they totally get this. You know they understand that without a health practitioner in their town they're not going to attract other people to the town. They're not going to build a community. Because if you're thinking, do I go rural, you know you'll be looking at what's the education, what's the health you know like. So before you make a decision to live in a rural community, you look at all of those things. And there's some communities like Quilby, for example, their council is doing a fabulous job, like they're trying to attract people to come and work in their community and so, for example, at the moment they provide housing for their council workers because they want to attract people to work for Quilby Council. So they're looking at ways in which they can make sure that there's support and infrastructure for the people as they come into the community. So you can't underestimate the impact of having a health practitioner in the community, what that does for the financial viability of a community as well.
Fran Avon:Yeah, it keeps it thriving and so yeah, and we are seeing that there are communities that are really throwing everything at it to make sure they can keep their health practitioners. And we're very conscious, even as a GP, like I'm thinking about going out to a rural community. What's the support for me? And so you know, having a program like ours where they can go, oh okay, that program's being delivered in that community, I can feel assured that if I go and work in that community, I'm going to have my own health care looked after and we also do see the family members of the GPs, because probably people think well, you, know a GP can they can, you know, look after their own family?
Fran Avon:and they do, and they can. But is it the best thing to do? Probably not, and so us being able to see family members of the GPs as well means that you know it's not mum or dad.
Sam Miklos:That's huge actually, especially with kids, yeah, as they're growing up in teenage years and things too. So the communities. Then you were saying like you would sit in that community and see any healthcare professional if there was like multiple practices or whatever, or from the local hospital or, yes, practicing independently away from another practice.
Dr John Buckley:you know, local physio.
Sam Miklos:Yeah, and how do they find you? Yeah?
Kate Coomber:I was going to say. No, I was thinking the exact same thing. Does it take time to drum up business.
Dr John Buckley:Yeah, that's where the foundation does a great job for me, yeah.
Fran Avon:We've got an amazing program manager, coral, and she just hits the phones. Now, fran, I had a little bit more money to be able to promote this, to make sure that people are aware that the program is available. And that's what's really exciting about starting to build these partnerships, because it's not just us on our own, you know, spreading the word, there'll be people out there that are going. You know they're coming next week. You know have you booked your appointment? And so that's sort of you know it is, you know, something that we hope will, you know, continue to grow and build over time. And you know, we hope that John can have more capacity. And you know we're not just in a community for the one day.
Fran Avon:He's got so many appointments that he has to stay for two, and you know, it's that sort of thing that we're hoping for.
Kate Coomber:Have you ever had or tried to go into a community where maybe you know there was a bit of protection over this is we want to do this ourselves, or you know we don't need outside help, or a health practitioner who is so used to flying solo and almost feels uncomfortable?
Fran Avon:Yeah, that was probably something we were very conscious of and, as John mentioned, you know we do a scoping visit before we go into a community, so we're not going to go into a community where there is that feeling of you know what are you doing, what are you coming into our patch for? But we haven't really encountered that yet.
Sam Miklos:Because do communities seek you out? Because if someone's listening to this and you're sending this out to our client base, can they ring the foundation and say, come to us.
Kate Coomber:If there's an opportunity, this is your funding moment.
Sam Miklos:Can they ring the foundation and say come to us if there's an opportunity.
Kate Coomber:Now you've got funding. This is your funding moment, or you know?
Fran Avon:And how do you choose? We're taking callers.
Dr John Buckley:Yes, got a generous sponsor in mind.
Sam Miklos:Maybe, I don't know, this is your pitch, right? Yeah, yeah.
Fran Avon:And really that's what it's about. You know we've got the capacity, We've now built a model that we can just replicate, and you know we've got all of the training in place, We've got all of the governance structures in place and you've got GPs on board to yes, we've got you know, at the moment we've got a number of GPs on board, but we have expressions of interest from lots of GPs.
Fran Avon:That's great. So it's not like the GP treating GP is the issue. It's can we have the funding to deliver this to as many communities as possible? So, as you say, if there is anybody out there listening, that goes wow, this is a program that we would love to support. We would love to talk to you, because it's not about what the foundation's doing. It's about making sure that those healthcare professionals are looked after and, ultimately, that the rural communities are looked after.
Kate Coomber:So if there's a rural community listening who think I really need help, we really need a bit of this type of support to get them in touch with you and it may not be obviously immediate, but just to be on your radar that this is an area that maybe we could focus on in the future.
Fran Avon:And you never know what happens. Like I was just chatting to a treating GP that's about to join us. We started chatting about 18 months ago and she said, oh, I really want to join the program. And I said, oh, I'd really love you to join the program too.
Fran Avon:But we don't have any sort of funding at the moment to do that and obviously with the Western Queensland PHN funding, we've now got that. And I said to her I said remember we started chatting 18 months ago and now it's happened and she's so excited about wanting to get out there in the communities and deliver this service and it's exciting for us to have. You know, we've now got a real mix. You know we've got male GPs. This is our first female GP and so that's really great as well.
Sam Miklos:So more funding would mean more of this same program.
Dr John Buckley:More locations.
Sam Miklos:Yeah, more locations are covered, obviously, than more GPs. Is there other visions that you have for the foundation? Like I know, you said, you're still pushing the snowball. Yes, but I sort of feel like you're not pushing it up a steeper hill maybe.
Fran Avon:And that's sort of the encouraging thing. There's positive signs. We're not there yet, but we really want to build on what we've got so far.
Sam Miklos:And so sorry, just that question you were like is there, if someone's you know listening and thinking, god, I want to donate, but is there? Is there other plans for the foundation?
Dr John Buckley:that you've got.
Sam Miklos:You've got these programs, but is there a big gap that maybe you're seeing clinically or that you think? Gosh, I wish we could fix that.
Fran Avon:Yeah, we've got. There's so many ways in which this program can grow and you know you talked before about, you know, not stepping.
Fran Avon:You know, like were there any resistance or anything like that, and what this has enabled us to do is to build relationships with the health practitioners in the communities. With the health practitioners in the communities, so if they, for example, one vision that I would love to see is that that GP could turn around to John and say, hey look, I want to go and have a month's leave. Do you have any capacity to look after my community while I'm gone? Because they now trust John, they know John, yes, and that enables that person to get that rest and that recuperation that they need. Another way of expanding the program is John could be accompanied by a specialist, you know, like if John's finding that there's a real, you know it could be diabetes it could be heart disease.
Fran Avon:What is it that's showing up in this community that you know? John goes as the GP and then he's accompanied by a specialist. There's the opportunity to expand the program to the community as well, but we wouldn't do that without the support of the local GP. But the local GP may go. You know what I'm really swamped right now. John, can you come and hang?
Kate Coomber:out with me for a week. They're looking for a more permanent person that they can't get, so this is just additional help. Yeah.
Fran Avon:So, as I said, I just love this program and I just say there are so many ways. It's not just about more communities, but it's about more services and it's more support and that sort of thing. So that might be the first time.
Sam Miklos:John's heard that and he's probably sitting here going, oh my gosh. When you see that vision for you, it's so nice to hear.
Dr John Buckley:If I could touch on I think we've already mentioned that disaster relief, one of the things that I have nothing to do with that the foundation does. It's small enough to be really nimble and Fran described every different practice or practitioner gets help in a way that's what they need. So people might have their own home destroyed or their practice destroyed or both, or they might need particular help with family, and the foundation is small and clever enough to help with that. And I just wanted to touch also on that resistance. I was lucky that I got to go to my town scoping visits with Coral, which was a chance to engage with heaps of practices in the hospital and just let them know we're coming. And one of the points I tried really hard to make was if you have an existing health relationship that works, I'm not here to interrupt that.
Dr John Buckley:I'm here if you want comprehensive care, because of course we can have telehealth between visits. I'm here if you are already seeing someone, but there are some things you want to talk about, even on a one-off basis. Or if you've got a great relationship and you've got good care fantastic and you don't want to see me, that's fine. So there was no resistance to the program. There was a I don't need it, but there was no one saying this is a bad idea. In fact, a lot of the people said I don't need it, but it's great that you're doing it. So I didn't sense, on that, scoping, any resistance.
Dr John Buckley:And from the other organisations we visited, like local councils, there was a lot of. I think Coral did a great job of explaining what it is and why and the benefit to those organisations of retention locally. So they were just starting to get an understanding of what the foundation's trying to do and that it wasn't somebody else coming sort of delivering a drive-in, drive-out service. That was nothing to do with them, that we're actually trying to help them in their community, and they started to get that as well. So hopefully we get a lot more support from the scoping visit's really important how often are you back in a community?
Dr John Buckley:The goal is about every three to four months and we're building the schedule depending on the need and the number of people who want to come. So our availability is quarterly but it does depend. If it's a bit slow on the uptake then we slow the visits back a little bit. But in between once I've seen someone with Medicare and with the availability of telehealth, now I can catch up with people in between easily. The only problem really is if they have an acute illness like a sudden sore abdomen, and of course I'm not in town. But at the first visit we talk about what are your options. If you need to see someone on a day I'm not here. A lot of the rest of the time I can be in contact really easily. But if you've got to see someone and examine them, they've got to see somebody but they've got that problem now.
Sam Miklos:So that's not a new problem. That's not new. John, are you seeing a lot of burnout in our health practitioners who are working rurally.
Dr John Buckley:It's lovely to give them a chance to talk about that, because it's masked and it's hidden and you don't understand. And for myself, even when I stopped doing some of my work, I felt my own brain needed to relax and unload somehow for a couple of months and I hadn't realized. So a lot of people don't realize until they start talking. And they start talking about stress and resilience and struggles and all the pressures that are on them and it becomes evident to them almost before me that they're at a level of burnout. And the question then is you know, what do you do about that? And sometimes just understanding and revealing it is the first step and then making your own decisions about what to do. So, yes, there is. So there's the obvious burnout and those who know it. But I think the more people have good care, the more they start to understand their own steps towards burnout, if not there already.
Kate Coomber:Because they're just not having an opportunity to talk. They're not thinking inward. They're treating other people constantly. You don't want to burden your partner or your family.
Sam Miklos:And, as Fran said, if you haven't had a break, and you've just kept going and going and going. You, if you haven't had a?
Dr John Buckley:break and you just kept going and going and going. You don't notice. Well, it's like the floods you were talking about before. I've got friends who are in Lismore and I've got friends who are in Townsville, and you know, your practice is destroyed, your house is destroyed, your family's disrupted, but somehow I'll just keep trying to see the patients and look after the community.
Dr John Buckley:I mean, what does that do to one's heart and soul and mind? It's mind? It's destructive, and yet that's that's what they do. So any support they get there. But later it's um. Friends in townsville this last week or two were being triggered just by the rainfall. Whether they were going to be impacted this time didn't matter. They were feeling anxious and this says it's almost a bit of ptsd and burnout sort of kicking in when the clouds gather. So better prepared but emotionally still struggling and in some ways more terrified.
Kate Coomber:And all the families, as you said. Yes, all impacted. You're right, the doctor goes straight back to work to make sure that they're there for everybody else.
Dr John Buckley:Yes, who's picking up the pieces and who's supporting the doctor, who's probably tired and grumpy? Yeah, exhausted.
Fran Avon:But it's also what we've seen a lot of is that you know doctors and health practitioners, they're caring people and so what they often do is they will put the needs of their patients before their own. And I had a classic example. I had a nurse ring me and it was not this John. We've got twos as part of the program, so another one of our treating gps, john, was already on the road. He'd hit the road ready to hit the skies. Actually it was a fly-in visit and, um, she rang me and she said, oh, have you got any appointments left? And I said we've got one appointment left. And she said, oh, I don't want to take that appointment if it's there's only one left. And I said no, you're exactly the person that needs this appointment. So she said oh, look, you know what? I'm just next door to where John will be doing the practice, so I'll wait and see and if nobody else takes the appointment, then I'll take it.
Fran Avon:And, as it turned out, she got the appointment and I spoke to John afterwards and I said how did that go? And he said, oh my gosh. He said she so needed to see a GP and yet she was willing to give up her appointment spot for somebody else, in case somebody more deserving, more needing came along, and I thought that's the sort of people that we're caring for, people who put others before themselves, and it is. You know, part of this challenge is the education I think GPs are on the journey of. We need to look after ourselves, but nurses and allied health professionals are still not quite there yet. But your health is more important, because if you're not healthy, then you're not there for your patients Completely.
Dr John Buckley:So the clinical director of the program is probably. Dr Margaret Kaye is probably our leading doctor in Queensland about doctors' health and that's again. She constantly brings the research and the knowledge and the thoughts about exactly what Fran was just talking about to the program and to myself and John. And no, having the name John was not a selection question, that's what you think, it was pure coincidence.
Dr John Buckley:But you know that focus on, you know, doctor's health and health practitioner. Health underpins what we're doing, but the longer term outcome really is community support and community services and by looking after the doctor's health. So the doctor's health might be the action, but the outcome is community health and community viability.
Sam Miklos:Absolutely. It's wonderful, Fran. Is there anything else about the Royal Doctors Foundation that we haven't covered? Is there anything else you're doing or stories you want to share?
Fran Avon:Yeah, there's probably, you know a number of stories of the things that we've made possible, and some of them are amazing, Like there's one story of and it's a bit of a sad story, but there's a doctor that we were given a grant and we were able to provide. They're called sandpiper bags, but they're a bit like an emergency trauma kit, and so they're set up in such a way that a GP that's trained in emergency medicine can grab the bag and just run and have everything that they need. And it's organised in such a way that if it's a snake bite, all of the snake bite stuff's there.
Fran Avon:If it's a more critical trauma accident bite, all of the snake bite stuff's there. If it's a more critical um trauma accident, all of the stuff's there. And we had had this beautiful application from um, a doctor based in wa, and I read his application I just loved it. It was like one of those ones where, you know, I just seem to attract track trouble wherever I. He said, you know, I was at the family holiday and a little kid got a fishing hook caught in their lip and had these range of stories of things that had happened to him along the course. And he said, and I do have my emergency kit. And he said, you know, and I use it quite often because I attract this trouble wherever I go. And so I thought, oh, he's got to get one of these bags.
Fran Avon:And, as it turned out, he, you know, not long after he got the bag, he was travelling out, you know, sort of Northern Territory, wa area and came across a car accident and it totally rolled the car and he was able to stabilise stabilize the patient, give them pain relief.
Fran Avon:Actually splintered a leg and the paramedics were obviously a long way away because they were out the middle of nowhere, and so he was able to do this all before the paramedics arrived and they just went. Oh wow, this is amazing, but this the that he himself had a tractor accident and his son was with him and he said to his son, can you go and get a mate who happened to be, you know, a doctor as well, but grab my sandpiper bag? And you know he was able to have his friend use the sandpiper bag on himself and you know sort of it was a very, very serious. You know accident that he had, but you sort of go wow, and you know sort of it was a very, very serious. You know accident that he had, um, but you sort of go wow, you know he's. He was able to save the life or at least alleviate you know very serious injuries for these people involved in the car accident, but it ended up helping himself as well, and that's that's one of my most amazing stories.
Fran Avon:And probably one of the things that sticks with me most is I remember one of the GPs. It was when I was first, you know, joined the foundation. I said, you know, tell me, you know, what does it mean to be a rural GP? And he said you know what he said.
Fran Avon:When you're a doctor in a you know, a big hospital, in a major centre, or you're working in your practice, if there's something that happens and you're the treating person in emergency or wherever it may be, the first question you ask is what are the injuries? How far out is the patient? When you're a rural GP, the first question you ask is who is it? Because you are very, very likely to have a personal relationship with this person and I hadn't really thought about that before and I thought, oh, imagine the impact of that. And then another treating GP had told me about the fact that he would caught out to a farm accident and unfortunately he wasn't able to save the person, and it was his son's best mate. And you go, how do you, how do you carry that?
Fran Avon:you know how do you cope with that? How do you come home and tell your son his? Best mate's no longer here family, friends, yeah yeah, so I think there's a lot of, as I mentioned before, there's a lot of weight that rural GPs carry, rural nurses carry, because it is so personal. Absolutely, and that's the stuff that's really stuck with me.
Kate Coomber:But it's also so rewarding and wonderful, and people living in these rural communities love what they do clearly, yes, so it's just so important that we can support them so they can remain doing what they do, and that's it.
Fran Avon:They're so humble, they're so committed so caring and I remember going to one of my first conferences and I thought these health practitioners really know how to party.
Sam Miklos:They're all from the bush.
Fran Avon:But somebody said to me at the time this is their only opportunity because they're the stalwart of their community, so they can't just go down to the local pub and let loose. So they really are holding their community in their hearts, in their hands. I think it's really and that's where I go People look at doctors and go oh, you know, they're well paid, they can look after themselves. What's the problem? But you go, my gosh. If you understood the burden that they're carrying, you would have a very, very different perspective.
Dr John Buckley:It's made a lovely point there too, fran that little bit of distance and isolation within the community. So, yes, you can go and play tennis and you can go swimming with the kids or whatever, but if you go to the pub you don't want to be seen to having more drinks than you should, or you maybe shouldn't be laughing out loud so much that people think you're drunk. And there's always that little bit of no matter who I am or what time of day I am, who I am in this community, and that's just a little thing. That makes it just a bit harder to fit in as fully as you might like, and some GPs are great at doing that. But there is always just this little barrier and also the possibility that there's a few of us in town that if something big happens, I might have to help and be available. So you, if you're in town unless you're away at a conference if you're in town, you're kind of always almost on.
Dr John Buckley:So if you're in town, unless you're away at a conference. If you're in town, you're kind of almost on, even if you're not on.
Kate Coomber:Yeah, yeah. Which is why they do need that space, don't they? Yes, they do those sandpiper bags you mentioned.
Sam Miklos:is that an initiative from the foundation or is that something that exists?
Fran Avon:It sounds like every yes, so it was an existing initiative and that's what we try and do.
Fran Avon:Yes, so it wasn't an existing initiative and that's what we try and do. We try and look for things that what do rural communities need? And so that was a campaign that we really got behind At the time of COVID. We really got behind giving all of our rural hospitals and communities access to COVID medihoods, which were a protective device, so a bit like a boy in the bubble type thing, but it went over the hospital bed and it protected the patients, the nurses, the visitors, the doctors from cross-infection and, once those medihoods were installed in the hospital, the relief of actually there's something between me and the patient to make sure I'm not going to get COVID.
Sam Miklos:Especially when they're the only one. I think in those times we were probably seeing more of the metropolitan areas and the impact. But if you actually think about that in a community like you're, it yeah.
Fran Avon:And I just was chatting to a doctor on Monday. We'd just given them an ear loop which is like a device where you can go in and sort of see what's going on in the ear and actually take out impacted wax. It doesn't sound like a really exciting product, but he said the difference this has made to our community. The fact that we have this technology means that they don't have to wait for treatment from the specialist coming into the community and they don't have to be travelling to the specialist services to get this treatment. So it's things like that that we go. What's a piece of equipment that we can provide to rural doctors, rural nurses, that will make their lives so much easier, and something like the E-Loop, for example. It's much less painless, so the patients get a better experience as well and they don't have to wait, they don't have to go through Doing things more regularly and not having to wait for build-ups.
Fran Avon:Yeah, and if you wait for treatment, sometimes the symptoms get a lot worse. Exactly, and that's what we find. A lot, john, isn't it?
Dr John Buckley:It's a lovely thing you've just mentioned. I was chatting with a colleague the other day and neither of us could think of anything else. There is nothing else we could think of where you could provide immediate and total relief of a symptom than removing any earwax plug.
Sam Miklos:Really.
Dr John Buckley:Because you go from I can't hear to I can hear, painlessly and completely. I mean, if I get a lot of pus out of an infection, you relieve the pain, but there's still some discomfort. If you remove earwax, you've gone from a problem to zero problem by the time the person leaves the room. And so, while it sounds simple, impact, it's like you know, Fred Holloway is fixing people's eyes A dramatic and complete difference. And if it's an older person, hearing is so critical, you know. And if they're wandering around with this problem and suddenly they can hear, wow, you know, it's an amazing thing to watch someone go oh, now I can hear, I can imagine what's the cost of that device.
Fran Avon:It's only a couple of thousand dollars.
Sam Miklos:Wow.
Fran Avon:And you know that's the sort of thing that we want to. I think that might be our next project. Yeah, you know we're just speaking with that doctor on Monday and you know the stuff. You know that's social, like if you can't hear, you can't socialise.
Fran Avon:So isolated in more isolated and he was a lovely, lovely gentleman, very humble, but just chatting with him you could just and it's like with all of the doctors that you talk to you just get that the passion. You're sort of chatting with him and he starts off really quietly and then he starts talking about oh, we did this with this patient and you can just hear.
Fran Avon:I just love what I do because I am making a difference in the lives of people. So it is really beautiful and I'm blessed to have this opportunity and to be able to ring somebody and say you know that application that you put in.
Fran Avon:I can't imagine we can help you how great and in some cases it's a lot of money, in some cases it's not much at all. Yeah, but it makes a huge difference. So they're the sorts of things that we're. You know, the GPs for Rural Docs is the program that John's a part of. That's our main focus at the moment, but you know we will continue to look for opportunities for how do we improve the health of people living in our rural and remote communities?
Kate Coomber:look, today cmr are going to make a donation to the foundation. Where do people go if people listening also want to contribute?
Fran Avon:so our website is rdforgau, so so fairly simple, easy to find.
Sam Miklos:There's a big button that says donate.
Fran Avon:So, you know, we've got, obviously, our crisis appeal running at the moment and we have our appeal to support the GPs for rural docs. But, you know, if people have a particular thing that they're interested in, we'd love to chat to them about it and just say, yeah, we're, you know, we're the people that you know really want to understand what it is that a rural community needs and how can we make that happen.
Kate Coomber:I love that. It's by asking those questions that you can have the bigger impact versus what you think might be impactful.
Fran Avon:And, as I said, every community is different.
Sam Miklos:So yeah, it's very personalised to that community. Yeah, thank you so much. How lucky are our healthcare professionals who are getting access to people like you, john, and your other John counterparts.
Kate Coomber:All the Johns, thank you.
Sam Miklos:Just for looking after our healthcare professionals, and I think it's just this whole other layer that no one, I think, has that great awareness of and that impact of the work that you're doing and the whole work that the foundation's doing when there's crises that happen.
Dr John Buckley:thank you both so much, it's been lovely hearing Fran talking about the foundation, because I knew it at the beginning when it was small and single purpose, and what it's become in its breadth of thinking about community, and what it's become in becoming a national organisation now. Even that surprised me. In that short time when I saw this program starting, I thought, wow, look at all this stuff they've been doing from a very small beginning with still a very small team. But I know the members many of the members of the board and they're such dedicated people and there's great innovation and good leadership. So I've been excited listening to Fran's responses today.
Sam Miklos:Yeah. I think the foundation's in good hands. You're doing an incredible job, fran like what a what a great few years, and I really hope that people lean in and support the foundation, because there's so much good that that you're doing and that you can continue to do so.
Dr John Buckley:Thank you for your time. Thanks so much. Real pleasure. You can continue to do so.
Sam Miklos:Thank you for your time. Thanks so much Real pleasure, thank you.
Kate Coomber:We acknowledge the traditional custodians of the land of which we meet who, for centuries, have shared ancient methods of healing and cared for their communities. We pay our respects to elders, past and present.
